Provider Demographics
NPI:1447212436
Name:RUBY, LAURA A (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:RUBY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:SPANGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1812 BALTIMORE BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-7146
Mailing Address - Country:US
Mailing Address - Phone:410-861-5256
Mailing Address - Fax:410-861-5258
Practice Address - Street 1:1812 BALTIMORE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-7146
Practice Address - Country:US
Practice Address - Phone:410-861-5256
Practice Address - Fax:410-861-5258
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR084575363LA2200X
PASP009133363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50062663OtherCAPITAL BLUE CROSS-WMG
PA1557021OtherGATEWAY-WMG
MD881498OtherCAREFIRST MD BCBS
PA107771OtherJOHNS HOPKINS
PA1635635OtherHIGHMARK BLUE SHIELD
MD881498OtherCAREFIRST MD BCBS
PA105069FLTMedicare PIN
PA1635635OtherHIGHMARK BLUE SHIELD